The College of Optometrists

Principles of examining a patient who presents with flashes and floaters

A200
If you are unable to carry out an adequate examination when you examine a patient who presents with flashes and/or floaters you must refer the patient to a practitioner who is competent to do this.
A201
You should ensure that front line or support staff are trained to deal with such a patient who contacts the practice. Patients should be told a diagnosis cannot be reached without an examination.
A202
If you carry out an examination you should continue until you detect a problem and can make a diagnosis or have sufficient evidence to decide what action to take.
A203
If you suspect a retinal break or tear you should, as a minimum: 
  1. take a detailed history and symptoms, looking for particular risk factors
  2. examine the anterior vitreous to look for pigment cells
  3. perform a dilated fundal examination, using an indirect viewing technique, and
  4. give appropriate advice to the patient, which you back up with written information.
A204
You should follow local protocols for the management and referral of these patients. 
A205
You should keep full and accurate records of all patient contact. 

See section on Patient records.

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